Clinical Assessment of Dental Monitoring Oral Hygiene Protocol: A Prospective Study

Objective: To assess the longitudinal relationship of oral hygiene in orthodontic patients taking weekly Dental Monitoring (DM) scans and to evaluate the validity and accuracy of DM artificial intelligence (AI) image analysis in identifying periodontal conditions Methods: Patients (n=24) from the UIC patient population seeking orthodontic therapy were evaluated clinically and with DM’s AI image analysis software for the presence of plaque, gingivitis, and recession over the course of 18 months. The periodontal indices used for clinical evaluation were the Orthodontic Plaque Index (OPI) and the Modified Gingival Index (MGI). The periodontal trends over time were compared to a control group (n=25) also undergoing orthodontic therapy at UIC. Student independent t-test and paired t-tests were used to investigate the mean differences between study groups and between time points for each group respectively. Sensitivity, specificity, positivity predictive value (PPV), negative predictive value (NPV) were calculated to evaluate AI and clinical assessment of plaque, gingivitis and recession. Results: The mean values for OPI and MGI after four months of treatment (T2) are lower in the DM group (OPI=1.96, MGI=1.56) than in control group (OPI=2.41, MGI=2.17), p-value < 0.05. There are statistically significant mean differences for OPI and MGI between time points (T2-T1) for each group, p-values < 0.001. There are mean differences for OPI and MGI between DM and control groups when comparing the time point differences (T2-T1), but these results are not statistically significant, p-values > 0.05. For AI detection of plaque, gingivitis, and recession, the sensitivity was 0.94, 0.96, and 0.99, the specificity was 0.53, 0.35, and 0.24, the PPV was 0.27, 0.29, and 0.70, and the NPV was 0.98, 0.96, 0.95 respectively. Conclusions: Current results show that the oral hygiene of orthodontic patients rapidly worsens over the first three months and plateaus after about five months of treatment. Results also show that weekly DM scans may improve oral hygiene over time in orthodontic patients. DM AI image analysis software has high sensitivity and NPV and moderate specificity and PPV for detecting the presence of plaque, gingivitis, and recession in orthodontic patients.